My insurance company raised my rates for 2010, but did not notify me until January 7th. They admitted in the letter that they failed to notify me and gave me the first two months of the year at the 2009 rate. If I had known about the increase I would have cancelled and joined the insurance offered by my wife’s employer. However, the enrollment period has passed. Is there a deadline for when the insurance company must notify you of an increase? As I mentioned, I would not have accepted the increase if they had notified me in a timely manner. Their delay caused me to miss the enrollment for my wife’s insurance. Can I legally force them to honor the 2009 rate because they waited so long to tell me about the increase? (I live in Georgia)

Health insurance companies are required to provide you with a 60 day notice of insurance company rates increase. By not actually charging you the higher rate until the the third month of the year, they are in compliance with federal health insurance regulations. They are not liable for your missing the open enrollment of your wife’s group health plan, as this is something that is not in their control. Open enrollment periods for group health insurance can fall on any month, depending on when that company first enrolled in their health plan. The open enrollment is on the annual anniversary of the original effective date of coverage. It is very possible, and happens quite often, that rate increases notices do not coincide with the open enrollment period of alternative health insurance options through a spouse.

You might try contacting the insurance company of your spouse’s group health plan to ask if they will accept you outside of open enrollment period, given the circumstances. They likely will not, but it certainly doesn’t hurt to ask.

Answer by Moderator - Friday, January 22, 2010 @ 12:11 pm

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